My right lateral incisor (#7) has been diagnosed with a cavity inside it, and dentist claims it needs a root canal. Interestingly, she has referred me to a root canal specialist who has the same very uncommon last name as hers. My previous dentist of last year’s x-rays didn’t indicate any issues with this tooth. And the outside of the tooth has never had work done on it and no surface cavity is showing. This tooth does stick ‘out’ at an angle in the front of my mouth a bit, thus is not receiving pressure from the lower teeth when chewing. I can’t find on the net any answer to is it possible to have a cavity inside of a tooth that has no outward signs of holes or wear?
(See Dr. Hall’s answer below.)
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You don’t have to go to the root canal specialist that your dentist recommends. Given the possible conflict of interest with your dentist and with this diagnosis you are questioning, I’d get another opinion from another specialist or general dentist.
About having a cavity in a tooth without having any external point of entry, no, that can’t happen. Decay has to start on the surface and eat its way into your tooth. When it goes deep enough, the bacteria causing the decay will infect the tooth, which will require a root canal treatment.However, it’s possible that your dentist is using different language to describe a problem called internal resorption. Internal resorption is a rare condition where the pulp of the tooth begins to eat away at the tooth from the inside. The cause isn’t known, but this is an inflammatory reaction, so it seems that there needs to be something that begins irritating the pulp. Since there is no history of decay in the tooth, the only way I can imagine this happening is if there was some trauma to the tooth from its sticking out further than your other teeth. But again, this is unlikely, since this is very rare, so my advice would be to find an endodontist for a blind second opinion to confirm the diagnosis. Check my post on how to seek a second opinion:
- Ask for a copy of the x-ray to take to the other dentist.
- Don’t let the second dentist know the name of any other dentist involved.
- Don’t even share the first diagnosis.
You could also send me a copy of the x-ray and I would be happy to render an opinion.
– Dr. David Hall
(There is also a pathology called external root resorption, which happens on the outside of the tooth. This could have the same x-ray appearance as internal resorption. Taking two x-rays at significantly different angles would help pin down whether the resorption is occurring inside the root or outside.)
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Hello Dr. Hall.
Thank you very much for your kind information. I did go get a second opinion, and what this dentist did was put a tiny piece of something really cold. He did it twice and neither time did I get to SEE what this was or where he was getting it from. He indicated my quick response indicating I felt it, was normal nerve reaction and thus doubted that there was pulp damage.